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Comprehensive ABC (HbA1c, blood pressure, LDL-C) control and cardiovascular disease risk in patients with type 2
Lovina A Naidoo1, Neil Butkow1, Paula Barnard-Ashton2
1Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Cardiovascular Journal of Africa
|May 24, 2024
Summary
Patients with type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD) have poor control of glucose, blood pressure, and lipids (ABC). This increases their risk for cardiovascular disease (CVD) events.
Area of Science:
- Endocrinology
- Cardiology
- Psychiatry
Background:
- Suboptimal control of glucose (A), blood pressure (B), and lipids (C) in type 2 diabetes mellitus (T2DM) increases cardiovascular disease (CVD) risk.
- Major depressive disorder (MDD) is associated with poorer health outcomes.
- Integrated management of T2DM, ABC control, and MDD is crucial for CVD prevention.
Purpose of the Study:
- To evaluate the impact of MDD on ABC control in T2DM patients.
- To assess CVD risk factors in T2DM patients with and without MDD.
- To analyze T2DM management within a South African private healthcare context.
Main Methods:
- Retrospective analysis of medical claims and electronic health records.
- Inclusion of 1,211 adult patients with T2DM and/or MDD.
- Data collected for the year 2019.
Main Results:
- Only 13% of T2DM+MDD patients achieved simultaneous ABC targets, compared to 7.1% of T2DM-MDD patients.
- Higher macrovascular complication admission rates were observed in the T2DM+MDD group (22.8%) versus T2DM-MDD (13.1%).
- Older T2DM+MDD patients showed better glycated hemoglobin and LDL-C control, but significantly more had repeat macrovascular admissions (12% vs 2.9%).
Conclusions:
- Comprehensive ABC control remains suboptimal in T2DM patients, especially those with MDD.
- MDD exacerbates poor ABC control, elevating CVD risk in T2DM patients.
- Managed-care settings require improved strategies for integrated T2DM and MDD management to reduce CVD events.
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